[87] Human Rights Watch, Prison is Not For Me: Arbitrary Detention in South Sudan, June 2012, https://www.hrw.org/sites/default/files/reports/southsudan0612ForUpload_1.pdf, pp. Rts. [74] In Togo, prophets can lock up and chain up to 150 people in a single prayer camp. In 2010, Indonesias health ministry launched the Indonesia Free from Pasung, a program that aimed to eradicate the practice by 2014. Trade is an important part of the American economy and a key driver of many industries. The Black community, in particular, is affected by mental health, often due to: Lack of health insurance. Gangs often threaten teens or adults with rape or murder, forcing entire families to flee their homes (World Report 2019, Human Rights Watch). L Guan et al., Unlocking Patients with Mental Disorders Who Were in Restraints at Home: A National Follow-Up Study of Chinas New Public Mental Health Initiatives, PLOS ONE 10(4) (2015), https://doi.org/10.1371/journal.pone.0121425 (accessed September 22, 2020). Gaborit and his team have also designed and delivered interventions to 3,500 children and adolescents in schools and community settings to help them make more informed decisions about whether to migrate. The Cohen Veterans Network and National Council for Mental Wellbeing believe that more must be done to improve access to care for everyday Americans. Depression, which is the leading cause of disability, is reported to be twice as common in women than men. In none of the hundreds of cases that Human Rights Watch documented were people with psychosocial disabilities allowed or given the opportunity to challenge their detention. [120] In addition, the UN special rapporteur on violence against women has condemned forced psychiatric treatment as a form of violence.[121]. [139] Partners in Health, Celebrating New Possibilities at Sierra Leones Only Psychiatric Hospital, June 5, 2020, https://www.pih.org/article/celebrating-new-possibilities-sierra-leones-only-psychiatric-hospital (accessed September 17, 2020). In some cases, the health center facilitates formation of peer support groups through the messaging application WhatsApp, links people to training on how to start a small business, and helps them get funding to start the business. 15; CAT; ACHPR, art.5; ACHR, art. UNHCR, 2014, Carrying a Heavy Load: Mayan Womens Understandings of Reparation in the Aftermath of Genocide [142] WHO, "Transforming services and promoting human rights in mental health and related areas," undated, https://www.who.int/activities/transforming-services-and-promoting-human-rights-in-mental-health-and-related-areas (accessed September 25, 2020). [101] Ghana: Faith Healers Defy Ban on Chaining, Human Rights Watch news release, November 27, 2019, https://www.hrw.org/news/2019/11/27/ghana-faith-healers-defy-ban-chaining. They have scars.[77] Esther, 37, a woman with a psychosocial disability who lived with her parents in a rural community in Apodaca, Nuevo Len, in northeastern Mexico, was shackled from the time she was a young girl. [34] WHO, Mental Health in the Workplace, https://www.who.int/mental_health/in_the_workplace/en/. If we want to save lives, save families and save futures we must reimagine our behavioral health system and take concrete steps to improving consumers ability to find the care they need, when they need it, and on their terms., Despite Strong Demand for Mental Health Services, Common Barriers Remain. [177], The CRPD further provides that health information be accessible to persons with disabilities and that the delivery of health services not discriminate on the basis of disability. CRPD/C/GC/1 (2014), http://daccess-ods.un.org/access.nsf/Get?Open&DS=CRPD/C/GC/1&Lang=E (accessed May 15, 2015), pp. Human Rights Watch phone interview with Joshua Duncan, program manager, Mental Health Coalition of Sierra Leone, September 25, 2020. Shackling impacts a persons mental as well as physical health. The trained staff in turn educate additional health center staff about the program and mental health. 90-92. In addition, even when there are services, they are often under-utilized or do not comply with human rights standards because of limited understanding and awareness of mental health. Human Rights Watch phone interview with Pascal Douti, September 3, 2019. This study of decentralization of mental health services in El Salvador supports the concerns of LAC mental health leaders and researchers that progress toward community mental health services has been slow and is far from being achieved. [95] Staff members hesitated to let Human Rights Watch enter the room asking: How will you enter? Share this via Telegram People with psychosocial disabilities who are shackled in homes and institutions experience physical abuse if they try to run away from institutions or dont obey the staff. Since the launch of QualityRights in Ghana in February 2019, around 15,000 people have enrolled in the course and around 7,430 people have completed the training. [66], In India, in January 2019, the media reported that thousands of people with mental health conditions were chained like cattle, their feet tied with iron chains and padlocked for days, months and years, in the state of Uttar Pradesh. Rafael Serrano psychiatric hospital in Puebla shackled him naked with a padlock during the nights for two-and-a-half weeks, and he was forced to defecate and urinate in his bed. [3] This encompasses the right to personhood, being recognized as a person before the law, and legal agency, the capacity to act and exercise those rights. [139] After long-term advocacy by organizations such as the Mental Health Coalition of Sierra Leone, chaining was banned in policy. Urge national governments to ban shackling of people with real or perceived mental health conditions and develop adequate, quality, and voluntary community-based support mental health services. Rodriguez supports the Shelter City Network, which relocates human rights defenders forced to move because of threats to their safety and provides psychotherapeutic treatment to Honduran survivors of torture, sexual violence and other crimes as they seek recourse through national and international justice systems. Decentralization of psychiatric services remains a major need in El Salvador, resulting in severe hardships on families. Migrants typically aim to improve their families quality of life by sending money home to purchase a house or pay private school tuition or by saving up and returning after a few years. The reasons are as varied as our our cultures' pressure due to machismo, a heavy reliance on faith versus therapy, and a general lack of education when it comes to what psychology and psychiatry can do . Along with hundreds of thousands of others, these Central Americans are migrating north this year seeking asylum, employment and family reunification. Mauricio Gaborit, PhD, a social psychologist who studies the migration of children and adolescents at Universidad Centroamericana Jos Simen Caas in El Salvador, has documented increasing rates of migration among adolescent girls and children under age 12. "We're waiting for the equivalent of a heart attack- the suicides . In India, thousands of people with mental health conditions were found chained like cattle in the state of Uttar Pradesh. Even in institutions where suitable toilets exist, residents do not always have access to them or they are inadequate. In addition, 1.9 million, or 5.1%, of adults in nonmetropolitan areas . 51. I eat porridge in the morning and if Im lucky, I find bread at night, but not every night. In countries where people believe mental health is a spiritual issue and robust mental health services are lacking, private institutions and faith-healing facilities flourish. [16] According to WHO, given the high incidence of sexual violence they suffer, women are also disproportionately affected by Post-Traumatic Stress Disorder (PTSD). Personal hygiene is a serious problem since people who are chained often do not have access to a toilet. James Ross, legal and policy director, provided legal review; and Babatunde Olugboji, deputy program director, provided programmatic review. What options do people have to stay home? she asks. Families or staff in institutions often make the person who is shackled stay naked, dress in very scant clothing, or wear an adult diaper, so it is easier for them to keep the person clean and they do not have to regularly wash soiled clothing. Provide adequate food, shelter, and health services to people with psychosocial disabilities. [112] Ghana: Faith Healers Defy Ban on Chaining, Human Rights Watch news release, November 27, 2019, https://www.hrw.org/news/2019/11/27/ghana-faith-healers-defy-ban-chaining. Malaki went from playing football in the Nyarugusu camp in Tanzania to the 2019 Special Olympics World Games in Abu Dhabi, United Arab Emirates. Lack of engagement with work. COVID-19 presents a serious threat to both physical and mental health, but policymakers in Indonesia have so far mostly . [103], In some cases, people are shackled to each other, forcing them to go to the toilet, bathe, eat, or sleep together. [86] Article 25, among other problematic provisions, states that a caregiver or a guardian of a person with a mental disorder shall not allow that person to walk freely in public places. In a country where people with psychosocial disabilities are stigmatized and subjected to abuse, such broad discretion given to authorities to restrict the freedoms of movement and liberties of a person with mental health conditions will facilitate further abuse and entrenchment of the problem. In many countries around the world, there is a widespread belief that mental health conditions are the result of possession by evil spirits or the devil, having sinned, displaying immoral behavior, or having a lack of faith. Informed consent is a bedrock principle of medical ethics and international human rights law, and forcing individuals to take medicines without their knowledge or consent violates their rights. We worked closely with partner organizations to visit private homes and institutions in Afghanistan, Burkina Faso, Cambodia, Ghana, Indonesia, Kenya, Liberia, Mexico, Mozambique, Nigeria, Sierra Leone, Palestine, Russia, the self-declared independent state of Somaliland, South Sudan, and Yemen. UN, Take Action for the Sustainable Development Goals, undated, https://www.un.org/sustainabledevelopment/sustainable-development-goals/ (accessed September 22, 2020). For example, Human Rights Watch research in Kenya found about 60 men, women, and children with real or perceived psychosocial disabilities chained, hidden from view, in the compound of the Coptic Church Mamboleo in Kisumu city in western Kenya. In the absence of mental health services, people with psychosocial disabilities can also be arbitrarily detained and chained in drug detention centers or prisons. Single session therapy has a lot of potential because its focused on giving the most help we can in the shortest amount of time, he says. In 15-minute interviews conducted while the Salvadoran immigration authorities processed migrants who had been deported from the United States for reentry into El Salvador, Gaborit and his colleagues assessed children and teens for depression, anxiety and somatization. New Jersey and Massachusetts have the lowest proportions, at 0.4% and 4.0%, respectively. [84] Human Rights Watch visit to Adwumu Woho Herbal and Spiritual Centre, Senya Beraku, Ghana, November 6, 2019. [133] Of these, 1,355 had been chained in Habeb hospital in Mogadishu, the capital, and 417 in the surrounding community. Accessibility means that health services should be affordable, situated within easy physical reach, and be offered to everyone without discrimination. Its not how a human being is supposed to be. 24, 2016). 50, 56-57; Amnesty International, Our Hearts Have Gone Dark The Mental Health Impact of South Sudans Conflict, July 2016, https://www.amnesty.org/download/Documents/AFR6532032016ENGLISH.PDF (accessed September 22, 2020), pp. A/39/51 (1984), entered into force June 26, 1987; Convention on the Rights of the Child (CRC), adopted November 20, 1989, G.A. In the case of social care institutions, NGO-run or traditional or religious healing centers, people sometimes used false pretenses to get their relatives to enter an institution, or simply provided no explanation at all. Worryingly, community leaders are reporting deaths in their communities, some of them related to the suspension of primary health care.. As a community, we need to attend to the physical, psychological, emotional, social, economic and familial needs of our people, says Ana Alicia Cbar Cataln, PhD, a clinical psychologist at Proyecto Aigl Guatemala and professor at Universidad del Valle de Guatemala (UVG). Mental health professionals' skills comprise a potentially robust . There is no space.[96] To walk in, one had to physically tiptoe over hands and feet. (2019, October 1). And across the region, the median percentage of countries health-care budgets allocated to mental health is 0.9%, the vast majority of which funds psychiatric hospitals (WHO-AIMS: Report on Mental Health Systems in Latin America and the Caribbean, 2013). It is mostly practiced in non-medical settings, by families, a faith healer, or non-medical staff, often in the absence of support or mental health services. [54] Human Rights Watch interview with mother of a man with a mental health condition, Bali, Indonesia, November 19, 2020 (full name and details withheld). Treaty Series No. If the family does not come to pick up the relative or abandons them at the institution, the person can end up spending many years or even the rest of their life shackled in the social care institution or healing center. 25; Karolina Kozik and Jean-Sbastien Spulchre, Disability Rights Bill Offers Hope in Congo, commentary, Human Rights Watch Dispatch, March 11, 2020, https://www.hrw.org/news/2020/03/11/disability-rights-bill-offers-hope-congo; Ghana: Faith Healers Defy Ban on Chaining, Human Rights Watch news release, November 27, 2019, https://www.hrw.org/news/2019/11/27/ghana-faith-healers-defy-ban-chaining; Cameroon: People With Disabilities Caught in Crisis, Human Rights Watch news release, August 5, 2019, https://www.hrw.org/news/2019/08/05/cameroon-people-disabilities-caught-crisis; Human Rights Watch, From Cradle to Grave: Discrimination and Barriers to Education for Persons with Albinism, June 2019, https://www.hrw.org/video-photos/interactive/2019/06/13/cradle-grave; Treated Worse than Animals, https://www.hrw.org/report/2014/12/03/treated-worse-animals/abuses-against-women-and-girls-psychosocial-or-intellectual. Travel restrictions have since been lifted but outpatient consultations at hospitals and health units remain suspended. To be a young person in El Salvador, Guatemala or Honduras is extremely stressful, he says. [171], The ICESCR specifies that everyone has a right to the enjoyment of the highest attainable standard of physical and mental health.[172] Under the ICESCR, governments are to progressively realize the right to health to the maximum of their available resources. 39/46, annex, 39 U.N. GAOR Supp. Some people cannot even afford a mask. Globally, an estimated 792 million people or 1 in 10 people, including 1 in 5 children, have a mental health condition. When the Special Olympics team had Malaki released, he got the opportunity and training to play football. In Nigeria, Human Rights Watch visited 28 facilities in 8 states and the Federal Capital Territory between 2018 and 2019, across which a few hundred people were arbitrarily detained, and where people were regularly chained or shackled. [92] UN Committee on Civil and Political Rights, General Comment No. [105], Shackling affects a persons mental as well as physical health. Physicians thought Bill Mitchell had dementia and could be a danger to himself or others, according to medical records. Res. In traditional or religious healing centers, there is no medical diagnosis and the basis for admission and discharge is left entirely to the discretion of the faith or religious healer. [40] Human Rights Watch interview with Ridha, family member, September 2020 (full name and details withheld). Traditional or religious healers: Traditional healers administer therapies based on theories, beliefs, and experiences indigenous to different cultures including ritual and herbal methods of treatment. In the same period this year, it has happened 37 times18 times in June alone.. They are also involved in various charitable activities. Kessler says that mental disorders are treated as acute, episodic ailments instead of chronic illnesses. The World Health Organization's new Mental Health Atlas paints a disappointing picture of a worldwide failure to provide people with the mental health services they need, at a time when the COVID-19 pandemic is highlighting a growing need for mental health support.The latest edition of the Atlas, which includes data from 171 countries, provides a clear indication that the increased attention . 61/106, Annex I, UN GAOR, 61st Sess., Supp. [126] In healing centers in countries such as Nigeria and Indonesia, men and women are chained next to each other, leaving women no option to run away if they encounter abuse.[127]. In one exercise, facilitators ask children to predict travel time to the United States (most underestimate the length of the journey), then use an enlarged map to measure distances and show that the route is thousands of miles long and can take months. 72. 16) at 49, U.N. Doc. The governments target was to ensure full coverage of over 65 million households in Indonesia through all 9,909 community health centers by the end of 2019. Traditional or spiritual healing centers are also considered types of rudimentary institutions. [69] In 2019, large prayer camps such as Mount Horeb detained dozens of people in chains. Because we currently lack the needed resources many of our. The Health Resources and Services Administration tracks health professional shortage areas, which are geographic areas, population groups, or health care facilities designated as having a shortage of health providers. [168], Under the CRPD, persons with disabilities have the right to choose their place of residence and with whom they live. [80] Human Rights Watch interview with Paul [not his real name], man with a psychosocial disability, Kenya, February 2020 (details withheld). CAB/LEG/24.9/49 (1990), entered into force November 29, 1999, art 14. In a few countries, government efforts at the national level to eradicate shackling have had some success in creating a roadmap to ending the practice. [50] Human Rights Watch interview with a volunteer in a local organization providing services to people with disabilities, Buea, Cameroon, January 2019 (name and details withheld). Mental health and addiction providers need adequate funding to hire skilled staff, employ evidence-based practices and adopt innovative technologies all of which will help us meet demand.. The chain is so heavy. El Salvador's citizens have faced multiple traumas in the past decades: war, gang violence, natural disasters and now COVID-19. [69] Helena Selby, Prayer Camps and Mental Illness, The Chronicle, undated, http://ghanaian-chronicle.com/prayer-camps-and-mental-illness/ (accessed March 28, 2012). Discover how we bring lifesaving care to those who need it most, Explore our work in more than 70 countries, Learn about the diseases and medical conditions we treat, Understand the complex crises we're responding to, A global movement providing lifesaving care, Get our annual financial statements and nonprofit tax filings, Understand our founding principles and the history of our work, Get the latest from our projects around the world, Read features from our quarterly magazine, Become a part of MSFs most important lifesaving work today, Discover the many ways you can support our lifesaving work, Individuals like you provide 90% of our funding, We make it easy to raise money to support the MSF movement, Learn how to get involved with our university student groups. The lack of a community-based mental health system continues to. A/6316 (1966), 999 U.N.T.S. In one case, a man with a psychosocial disability spent 37 years chained in a dark, sweltering cave in the mountains in Wadi Al-Sabab, Saudi Arabia. Thus, an While countries are increasingly starting to pay attention to the issue of mental health, the practice of shackling remains largely invisible. [76], In Mexico, officials from the Office of the Prosecutor for Protection of People with Disabilities told Human Rights Watch: Families tie them [people with psychosocial disabilities] up regularly. Founded in 1969, the National Council for Mental Wellbeing is a membership organization that drives policy and social change on behalf of over 3,100 mental health and substance use treatment organizations and the more than 10 million children, adults and families they serve. Ensure that people who have been released from state and private institutions have access to psychosocial support and social services. Mental health shortages range in severity across the country. From health insurance to prescription drug prices, the cost of healthcare has been a political issue for decades. [74] Why Pakistans Poor Seek Mental Health Cure at Shrine, BBC News Online, September 29, 2016, https://www.bbc.com/news/world-asia-37495538 (accessed March 23, 2020). QualityRights also focuses on empowering advocates and self-advocates to influence policy-making and push for national legal reforms to meet the standard set by the CRPD. Despite such accomplishments, many psychologists in the Northern Triangle countries feel that they are largely working in isolation with little support and few resources. I really wanted to help my aunty but couldnt. Ridha, a family member with relatives shackled in Oman, said: Its time for governments to step up so that families arent left to cope on their own.. . [3] United Nations Committee on the Rights of Persons with Disabilities (CRPD Committee), General Comment No. [62], Human Rights Watch has found evidence of shackling across60 countries across Asia, Africa, Europe, the Middle East, and the Americas. And women and girls are not supported to manage their menstrual hygiene, for example through the provision of sanitary pads. [48] In March 2019, six people with mental health conditions, including three children, were chained to logs in a Christian faith healing center in Montserrado, Liberia because they were accused of witchcraft. [138] Until 2018, people with mental health conditions being admitted to the psychiatric hospital were asked to pay for a padlock and chain prior to admission. Look at the data on educational progress and challenges. The ACHR has been ratified by Argentina, Bolivia, Chile, Colombia, the Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, and Peru; Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights (Protocol of San Salvador), O.A.S. Human Rights Watch, Like a Death Sentence, https://www.hrw.org/report/2012/10/02/death-sentence/abuses-against-persons-mental-disabilities-ghana; Chained Like Prisoners," https://www.hrw.org/report/2015/10/25/chained-prisoners/abuses-against-people-psychosocial-disabilities-somaliland; Living in Hell, https://www.hrw.org/report/2016/03/20/living-hell/abuses-against-people-psychosocial-disabilities-indonesia; "Nigeria: People With Mental Health Conditions Chained, Abused," Human Rights Watch news release, https://www.hrw.org/news/2019/11/11/nigeria-people-mental-health-conditions-chained-abused. TRADEMARKS. [138] Human Rights Watch phone interview with Joshua Duncan, program manager, Mental Health Coalition of Sierra Leone, September 25, 2020. CRPD/C/GC/1 (2014), http://daccess-ods.un.org/access.nsf/Get?Open&DS=CRPD/C/GC/1&Lang=E, para. [165] CRPD, art. They run away whenever they see me. [22] WHO, Mental health: massive scale-up of resources needed if global targets are to be met, June 6, 2018, https://www.who.int/mental_health/evidence/atlas/atlas_2017_web_note/en/ (accessed July 22, 2020). [72] In Morocco, the government in 2015 released over 700 people chained in one shrine alone, about 50 kilometers from Marrakesh in the southwestern part of the country. 40, entered into force November 25, 2005. And we promote greater understanding of mental wellbeing as a core component of comprehensive health and health care. Combined, medical and behavioral health costs $37.6 to $67.8 billion (yes, with a B) a year in lost productivity. They are abusing our rights over here.[84]. [43] Human Rights Watch, Like A Death Sentence, https://www.hrw.org/sites/default/files/reports/ghana1012webwcover.pdf; Treated Worse Than Animals, https://www.hrw.org/sites/default/files/report_pdf/india1214.pdf; Living in Hell: Abuses against People with Psychosocial Disabilities in Indonesia, March 2016, https://www.hrw.org/sites/default/files/report_pdf/indonesia0316web.pdf. 58 (1982), entered into force October 21, 1986. About 80 percent of people with disabilities, including people with psychosocial disabilities, live in middle or low-income countries where it is often challenging to access healthcare,. [49] Human Rights Watch interview with Benjamin Ballal, survivor of shackling and secretary general for cultivation at Cultivation for Users Hope, Nairobi, February 15, 2020. [14] "Suicide: One Person Dies Every 40 Seconds," WHO news release, September 9, 2019, https://www.who.int/news-room/detail/09-09-2019-suicide-one-person-dies-every-40-seconds (accessed September 22, 2020). In El Salvador, learning disabilities and speech and language disorders are not considered disabilities for purposes of statistical reporting at the national level (MINED, 2015). 49) at 65, UN Doc. [18] Between 76 and 85 percent of people with mental health conditions who live in middle or low-income countries do not have access to mental health services. I stay in a small room with seven men. In the worst of cases, depression can lead to suicide - an estimated 63,000 people kill themselves every year in the Americas. Celina de Sola 04:32 Feb 28, 2023. [91] Human Rights Watch interview with Sheu Abdukhaleed, traditional healer, Ibadan, Nigeria, September 17, 2019. 6 and 9; UN Committee on Economic, Social and Cultural Rights, General Comment 14, The right to the highest attainable standard of health (Twenty-second session, 2000), U.N. Doc. In Nigeria, amongst the people Human Rights Watch interviewed, the youngest child chained was a 10-year-old boy and the oldest person was an 86-year-old man. Help us continue to fight human rights abuses. The ACRWC has been ratified by Benin, Burkina Faso, C. American Convention on Human Rights (ACHR), adopted at the Inter-American Specialized Conference on Human Rights, San Jos, Costa Rica, 22 November 1966. This should include development of psychosocial support services and integration of mental health services in the primary healthcare system. But once he was admitted, his wife really began to worry. [15] Discrimination, gender-based violence, socioeconomic disadvantage, income inequality, subordinate social status and the pressure of multiple roles are among the most cited at-risk factors that contribute to poor mental health among women. [106] Human Rights Watch, Living in Hell, https://www.hrw.org/report/2016/03/20/living-hell/abuses-against-people-psychosocial-disabilities-indonesia. Im never invited to happy occasions, weddings or birthdays with my family. Human Rights Watch phone interview with Dr Irmansyah, psychiatrist and health ministry official, September 23, 2020. Based on research on shackling across 60 countries, Human Rights Watch has found that the key factors to ensuring the success of governmental programs to end shackling include: With the right kind of support, people with mental health conditions can live and thrive in their communities. Comprehensively investigate state and private institutions in which people with mental health conditions live, with the goal of stopping chaining and ending other abuses. Shackling occurs in many countries that are party to international and regional human rights treaties that prohibit abusive treatment and related rights. For example, Delaware requires 15 more mental health providers to resolve its shortage, whereas Texas needs an additional 638. 1, U.N. Doc. [32] Graham Thornicroft et al., Undertreatment of People with Major Depressive Disorder in 21 Countries, The British Journal of Psychiatry 210,2 (2017), doi:10.1192/bjp.bp.116.188078 (accessed September 16, 2020), pp.
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